Ear, Nose & Throat (ENT) / Head & Neck / Laryngectomy

Cat 1 · 30 days

appointment within 30 calendar days. - Pre-operative head and neck surgical education for patients whose surgery will likely have a significant impact swallowing and/or communication function. - Laryngectomy patients who has the potential to require more complex, or emergent care if assessment is delayed or is preventing eating and drinking and has suspected or confirmed: - voice prosthesis leakage - voice prosthesis dislodgement - loss of tracheoesophageal voice - tracheostomal airway changes (stenosis) - pulmonary secretion plugging or excessive secretions - deterioration in swallowing function or in oral intake - Laryngectomy patients (within 3 months of laryngectomy surgery) for tracheostomal and voice prosthesis care and education that if delayed has the potential to require more complex or emergent care. - Laryngectomy patients currently receiving or within 3 months of radiotherapy treatment that if delayed has the potential to require more complex or emergent care. - Laryngectomy patients requiring optimisation of non-symptomatic candida management to prolong voice prosthesis lifespan. - Laryngectomy patients requiring MASS HME Scheme prescription of humidification products where current supply will not last 30 days. - Tracheostomy patients requiring speech pathology intervention for swallowing, communication and/or humidification optimisation that if delayed has the potential to require more complex or emergent care. - Post-head and neck surgical patients with trismus within 3 months of initial surgery and/or that is painful, impacting oral intake, oral care and/or communication. - Suspected or confirmed oropharyngeal dysphagia in head and neck cancer or surgical population and has the potential to require more complex, or emergent care if assessment is delayed or is preventing eating and drinking. - Indicators for this category: - History of recurrent chest infections. - Co-occurring dysphonia or speech impairment. - Gagging, choking, and/or coughing when swallowing food/fluids. - Food or liquids coming back up to throat, mouth, and/or nose after swallowing. - Patient feels like foods or liquids have been getting stuck in their throat AND are very concerned/anxious about swallowing problem. - Weight loss/loss of appetite/food avoidance. - Co-occurring chronic respiratory or neurological condition/s.

Cat 2 · 90 days

appointment within 90 calendar days. - Laryngectomy patients requiring MASS HME Scheme prescription of humidification products where current supply will not last 90 days. - Laryngectomy patients requiring optimisation of tracheoesophageal voicing (including hands-free speech) or electrolaryngeal voicing. - Laryngectomy patients requiring optimisation of pulmonary humidification and rehabilitation (including olfaction) where there is no acute compromise to respiratory function. - Suspected or confirmed oropharyngeal dysphagia in a head and neck cancer or surgical or laryngectomy or tracheostomy population/s and condition is likely to require more complex care if assessment is delayed beyond 90 days. - Indicators for this category: - Patient feels like foods or liquids have been getting stuck in their throat and are not concerned. - Stable oropharyngeal dysphagia and/or to review progress/management plan. - Post-head and neck surgical communication disorders (including speech impairment and dysphonia) that are likely to require more complex care if assessment is delayed beyond 90 days with: - Impact on functional communication and ability to participate in life roles resulting in potential impact on quality of life. and - Potential risk of depression and/or anxiety, and/or carer burden as a result of communication impairment which may require more complex care.

Cat 3 · 365 days

appointment within 365 calendar days. - Laryngectomy patients requiring yearly prophylactic tracheostomal and voice prosthesis reviews and/or changes. - Stable tracheostomy patients requiring periodic review of swallow and communication function. - Post-head and neck surgical communication disorders (including speech impairment and dysphonia) that will unlikely require more complex care if not seen within one (1) year. - Post-head and neck surgical patients with trismus that is non-symptomatic and stable.